Overuse Injuries on the Rise Among Young Athletes

Ernesto Luciano-Perez, MD, of Virginia Orthopaedic & Spine Specialists

Ernesto Luciano-Perez, MD, Medical Director of Bon Secours Sports Medicine

It is estimated that more than six million individuals play organized baseball every year in the United States. As baseball’s popularity has increased, so have the number of shoulder and elbow injuries among athletes. In fact, the percentage of elbow reconstructions on high school pitchers compared to college-level pitchers has increased dramatically over the last twelve years.

A number of studies have linked the amount of pitches that youth baseball pitchers throw during the spring season to significant shoulder and elbow pain. These studies have also found that throwing curve balls and sliders increases a pitcher’s risk of shoulder pain. Since this new research has come to light, many recommendations have been made regarding pitch counts and types of pitches for youth pitchers.

Since 2007, Little League Baseball has instituted guidelines both for the number of innings pitched and pitch counts. Starting in 2009, Little League Baseball has added additional regulations prohibiting a player from player pitcher and catcher in the same game – to further reduce the risk of overuse injuries in players.

Measures like these have been met with a great deal of clinical support. In a recent ten year prospective study looking at the injury rates, the overall risk of a young pitcher sustaining a serious throwing injury within ten years was 5%. Those athletes who pitch more than 100 innings per year were 3.5 times more likely to be injured than those who pitched less than 100 innings. In a different study, researchers found that a group of pitchers who pitched eight months during the year had significantly more injuries than a group that pitched five and a half months during the year. This injured group also had more games played, more innings per game pitched, and more pitches per game than the uninjured group. The injured group, in general, also included more starting pitchers, pitchers that pitch in more showcases, and pitchers with a higher velocity than the uninjured group. Moreover, these researchers found that the athletes who had a shorter season tended to pitch with arm pain and fatigue, an important factor in preventing injury.

It is clear that with baseball’s increasing popularity, these injuries are going to become even more common. To help combat these shoulder and elbow injuries, it is important for sports and medical specialists to develop strategies to prevent injuries in these young athletes. Both parents and coaches should become familiar with the most recent guidelines published by Little League Baseball and the USA Baseball Medical and Safety Advisory Committee. By monitoring and limiting the amount of 1) innings pitched, 2) the number of pitches per game and per year, and 3) the number of months playing baseball, we can help young baseball athletes avoid the painful consequences of overuse injuries.

Next week we will touch upon helpful hints to try to prevent these overuse shoulder and elbow injuries from occurring.

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Dr. Ernesto Luciano-Perez specializes in Sports Medicine, Arthroscopic Surgery and General Orthopaedics. He received his board certification in 1993 from the American Board of Orthopaedic Surgery. Dr. Luciano-Perez’s affiliations and memberships include Fellow of the American Academy of Orthopaedic Surgery, Arthroscopy Association of North America, American Medical Association, Virginia Orthopaedic Society and Southern Orthopaedic Association.

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